This benefit covers an emergency at any registered emergency/hospital casualty facility when you require immediate medical treatment due to an accident/trauma; illness or child emergency illness.*

*applicable to Ultimate Gap

This benefit covers an emergency at any registered emergency/hospital casualty facility when you require immediate medical treatment due to an accident; illness or child emergency illness.**

**applicable to Plus Gap

This benefit covers an emergency at any registered emergency/hospital casualty facility when you require immediate medical treatment due to an accident and illness.***

**applicable to Gap Assist | Gap Lite

Options

Ultimate Gap | Plus Gap | Gap Assist | Gap Lite | Corporate Comprehensive | Corporate Base

  Gap Only | Exact Cover | Exact with Gap and Copay

Description:

This benefit covers an emergency at any registered emergency, hospital, or casualty facility when you require immediate medical treatment due to an accident and trauma, or illness. 

Accident / Trauma Benefit; Illness Benefit and Child Emergency Illness Benefit is covered as a stated benefit on the Ultimate Gap options. For these options, a medical aid statement is not a requirement.

Accident Benefit; Illness Benefit and Child Emergency Illness Benefit is covered as a stated benefit on the Plus Gap Cover options. For these options, a medical aid statement is not a requirement.

Accident Benefit is covered as a stated benefit on the Gap Assist and Gap Lite options.  For these options, a medical aid statement is not a requirement.

Illness Benefit covers the gap portion only on the Gap Assist and Gap Lite options.  For these options, a medical aid statement is a requirement.

Important points to consider:

• Only covers for treatment between 18:00pm and 7:00am weekdays excluding weekends and public holidays. *Applicable to Illness Benefit and Child Emergency Illness Benefit only*
• Illness benefit, applicable to any beneficiary 9 years and older.
• Child emergency illness benefit, applicable to children 8 years and under.   
• Ambulance costs are not covered by this benefit.
• We will cover a GP’s emergency facility where no hospital emergency is available within a 30km radius within the above stated benefit limits.
• ICD-10 Diagnosis codes are used to validate claims against this benefit, please ensure that your provider uses the correct ICD-10 and treatment codes